deliriumtool.com

Bedside reference for ICU delirium: screening, prevention, and management at the point of care.

Reference aid only. This tool supports — it does not replace — clinical judgment, local protocol, and prescriber/pharmacy review. It is not a validated decision-support device, a diagnostic instrument, or an order set. Verify every recommendation against the cited primary sources and your institution's policy. Provided "as is", without warranty.

Adult ICU tool (deliriumtool.com), the main bedside reference:

• Risk factors: a predisposing + precipitating checklist. The tally is a non-validated heuristic and points you to the validated PRE-DELIRIC / E-PRE-DELIRIC models.
• CAM-ICU + RASS: the two-step CAM-ICU flow (document the RASS, then the four features; Feature 3 derives from the documented RASS per the Vanderbilt worksheet) with motor-subtype classification.
• ABCDEF bundle: the ICU Liberation prevention bundle as a working checklist.
• DELIRIUM(S): a causative-factor review mnemonic.
• Treatment. The CAM-positive algorithm: treat causes → intensify non-pharmacologic measures → pharmacologic safety options.
• Medications: pharmacologic options with cautions, plus a deliriogenic-medication review with per-agent toggles.
• Documents: print-ready PDFs generated entirely in the browser.

Pediatric ICU tool (deliriumtool.com/peds): CAPD, pCAM-ICU, and psCAM-ICU screening with age-banded developmental anchors and an SBS/RASS arousal gate, the pediatric prevention bundle, weight-based dosing references, and an in-browser summary report. Same privacy model.

ED screening tool (deliriumtool.com/ed), delirium screening for older emergency-department patients: the two-step DTS → bCAM pathway, the bCAM directly for high-risk screening, and the 4AT, with the validated scripts and thresholds, an unable-to-assess gate, guideline-backed next steps, and a de-identified print/PDF summary. Same privacy model.

Step-down / progressive-care tool (deliriumtool.com/stepdown), delirium screening for the verbal, monitored non-intubated (intermediate-care / step-down) patient, where the CAM-ICU loses sensitivity: the CAM-IMC additive screen with a RASS arousal gate, an admission risk score, and a multicomponent non-pharmacologic prevention bundle, with a de-identified print/PDF summary. Same privacy model.

Bedside template designer (deliriumtool.com/templates), customize and print laminate-ready reference sheets: a per-patient ICU Delirium Rounding Tool (landscape, marked with a dry-erase pen), a unit-level SPA Quick Reference poster, a Peds Delirium Card Set (arousal gate, screen routing, CAPD, ps/pCAM-ICU, action cards, and attention picture cards for the bedside ring), a PICU Delirium Workflow poster with the 10-second rounds script, an ED Delirium Card Set (RASS gate, DTS → bCAM flowsheets, the 4AT, and an act-on-a-positive card), an ED Delirium Workflow poster with the disposition hand-off script, a Step-Down Delirium Card Set (RASS gate, CAM-IMC scoring, admission-risk worksheet, prevention bundle, and an act-on-a-positive card), and a Step-Down Delirium Workflow poster with the transfer hand-off script. Pick which sections, lines, and deliriogenic medications print, reword any line, add your unit's own lines and sections, set the sedation target, and choose the print size and font, then print at 100% on Letter paper or save the generated PDF. Every medication prints with its own check-off square at any selection size. Names are generic-only by default (brand names are an opt-in). The configuration autosaves locally and can be shared as a link or JSON file. It carries protocol settings only, never patient data.

Everything runs in your browser. The tool captures no patient identifier, sends nothing to a server, makes no third-party network requests, and includes no analytics. Anything you type stays on your device unless you choose to export or share it. Shareable links carry only de-identified content and are never stored server-side. Do not enter PHI into fields you intend to share.

npm install
npm run dev      # builds, then serves with Wrangler at the printed localhost URL

After npm run build, the contents of dist/ are a self-contained static site. You can also open dist/index.html directly; it works offline.

A self-hosted copy can ship a default protocol configuration. When served over http(s), the app reads a settings.json placed next to the page (e.g. https://your-host/settings.json) and applies it to the Setup tab: screening tool, RASS target, review cadence, and the governance fields. Generate one from Setup → Save settings (it downloads settings.json), then drop it beside index.html.

• These are unit/protocol settings only, never patient data. Values are validated on load: unknown keys are ignored, lengths are bounded, and dropdowns are constrained to their allowed options.
• To use a different filename, add a same-origin <meta name="settings-src" content="my-unit.json"> to index.html.

npm test         # data-accuracy unit tests + Playwright (functional, a11y, visual)
npm run test:unit
npm run test:e2e

The unit suite pins every clinical cut-point, band, and dose string to its cited value. A wrong threshold is treated as a patient-safety bug. The Playwright suite covers keyboard operation, screen-reader semantics, print/PDF output, and visual regressions.

A static site served by Cloudflare Workers (Static Assets), via Wrangler.

npm run deploy   # or connect the repository for push-to-main deploys

Every instrument, threshold, score band, and dose, along with the primary source it maps to, is documented in docs/CLINICAL_METHODOLOGY.md, with the source archive indexed in references/INDEX.md. The methodology document also records the adoption and maintenance model (MIT licensing and adopter responsibility, source-cycle triggers, change log, and instrument-deviation register). Corrections backed by a primary source are welcome. See CONTRIBUTING.md.

This repository's own code and documentation are released under the MIT License (© 2026 dotCooCoo): free to use, modify, and distribute, provided the copyright and licence notice are retained. The clinical instruments it references (CAM-ICU, RASS, ICDSC, CAPD, pCAM-ICU, psCAM-ICU, SBS, the ABCDEF/ICU Liberation bundle, PRE-DELIRIC, and others) are the work and copyright of their respective authors and are used as cited; see docs/CLINICAL_METHODOLOGY.md. The MIT "as is, no warranty" terms are separate from, and do not replace, the clinical disclaimer that this is a reference aid only, not a validated decision-support device.

Anyone may adopt, deploy, or fork it. If you do, you own the clinical governance, validation, and any regulatory determination for your deployment: confirm the content against current sources for your population and obtain whatever local clinical, pharmacy, and information-governance review your institution requires. The maintainers provide it as reference material and take no responsibility for how it is used or for any clinical decision or outcome. See docs/INTENDED_USE.md and §6.1 of the methodology.

• CONTRIBUTING.md: how to propose changes (clinical changes must cite a source and add a test).
• SECURITY.md: report a vulnerability or a clinical-correctness issue privately.
• Code of Conduct.